scholarly journals ‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period

2019 ◽  
Vol 16 (21) ◽  
pp. 4253 ◽  
Author(s):  
Emma Carlin ◽  
David Atkinson ◽  
Julia V Marley
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Western Australia ◽  
Perinatal Depression ◽  
Perinatal Period ◽  
Screening Tools ◽  
Depression And Anxiety ◽  
Aboriginal Women ◽  
Anxiety Screening ◽  
Mood Scale

Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.

scholarly journals Adjusting an Available Online Peer Support Platform in a Program to Supplement the Treatment of Perinatal Depression and Anxiety

2016 ◽  
Vol 3 (1) ◽  
pp. e11 ◽  
Author(s):  
Amit Baumel ◽  
Stephen M Schueller
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mood Disorders ◽  
Emotional Support ◽  
Perinatal Depression ◽  
Health Resources ◽  
Depression And Anxiety ◽  
Study Results ◽  
Health Products ◽  
The Impact

Background Perinatal depression and anxiety are common and debilitating conditions. Novel, cost effective services could improve the uptake and the impact of mental health resources among women who suffer from these conditions. E-mental health products are one example of such services. Many publically available e-mental health products exist, but these products lack validation and are not designed to be integrated into existing health care settings. Objective The objective of the study was to present a program to use 7 Cups of Tea (7Cups), an available technological platform that provides online peer (ie, listener) based emotional support, to supplement treatment for women experiencing perinatal depression or anxiety and to summarize patient’s feedback on the resultant program. Methods This study consisted of two stages. First, five clinicians specializing in the treatment of perinatal mood disorders received an overview of 7Cups. They provided feedback on the 7Cups platform and ways it could complement the existing treatment efforts to inform further adjustments. In the second stage, nine women with perinatal depression or anxiety used the platform for a single session and provided feedback. Results In response to clinicians’ feedback, guidelines for referring patients to use 7Cups as a supplement for treatment were created, and a training program for listeners was developed. Patients found the platform usable and useful and their attitudes toward the trained listeners were positive. Overall, patients noted a need for support outside the scheduled therapy time and believed that freely available online emotional support could help meet this need. Most patients were interested in receiving support from first time mothers and those who suffered in the past from perinatal mood disorders. Conclusions The study results highlight the use of 7Cups as a tool to introduce accessible and available support into existing treatment for women who suffer from perinatal mood disorders. Further research should focus on the benefits accrued from such a service. However, this article highlights how a publicly available eHealth product can be leveraged to create new services in a health care setting.

A meta-analysis examining the association between maternal perfectionism and perinatal depression and anxiety

2021 ◽  
Author(s):  
Clare Evans ◽  
Jana Kreppner ◽  
Peter J Lawrence
Keyword(s):  
Mental Health ◽  
Perinatal Depression ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Perinatal Period ◽  
Perinatal Mental Health ◽  
Depression And Anxiety ◽  
Eligibility Criteria ◽  
Prior Review ◽  
Mental Health Difficulties

Background: Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety. Method: We followed PRISMA guidance (PROSPERO: 42019143369 ), estimated weighted effect sizes and tested possible moderators: timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age; and rated study quality. Results: 14 studies met eligibility criteria. Perfectionism as a whole, and the perfectionistic concerns dimension, were moderately correlated with common maternal perinatal mental health difficulties r= 0.32 (95% Confidence Interval = 0.23 to 0.41). In sub-group analyses, perfectionistic concerns were associated with depression (r=.35, 95% CI = 0.26 – 0.43). We found no evidence of significant moderation of associations. Limitations: Included studies had methodological and conceptual limitations. Studies inconsistently examined both perfectionistic concerns and strivings, nor anxiety as well as depression. Conclusions: Perfectionism, especially perfectionistic concerns, appears to be an important feature of common maternal perinatal mental health problems. While further research is warranted, screening and identification of perfectionism in the perinatal period may help focus resources for intervention, reducing the prevalence of perinatal mental health difficulties.

scholarly journals The Role of Maternity Services in Reducing the Prevalence and Cost of Perinatal Depression and Anxiety during COVID-19 in England

2021 ◽  
Vol 4 (4) ◽  
Author(s):  
Rachael Maree Hunter
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Maternity Care ◽  
Perinatal Depression ◽  
Mental Health Problems ◽  
Perinatal Mental Health ◽  
Depression And Anxiety ◽  
Maternity Services ◽  
The Impact

In 2020 the novel coronavirus outbreak (COVID-19) was declared a global pandemic. Pregnant women have been recognised as a group specifically at risk during this time due to the impact that the COVID-19 infection may have on the health of the birthing person and the unknown impact of vertical transmission to the fetus. Pregnant women also have a recognised risk of perinatal mental health problems including depression and anxiety. The aim of this paper is to summarise the impact of the COVID-19 pandemic and associated infection control measures on perinatal depression and anxiety in England, the cost of the additional impact and the role of English National Health Service (NHS) trusts and maternity services in reducing the impact and cost. Studies including systematic reviews and meta-analyses have found a 3 to 5 fold increase in perinatal depression and anxiety during the COVID-19 pandemic compared to non-pandemic times. This increased prevalence, if also seen in England, is at a potential cost to society of £10.6 billion for depression and £6.9 billion for anxiety, including a cost to the health care sector of £649 million and £1.7 billion respectively. Health care Trusts and maternity services have an important role to play in reducing this cost, not just in providing maternity care, but also in monitoring the health of the population and referring onwards where needed. Modest improvements in the availability of social support including improved partner involvement during pregnancy and labour and support given by health care staff during maternity care have the potential to reduce the risk of perinatal depression and anxiety. Signposting to and provision of perinatal mental health services, particularly for women at risk, is also likely improve outcomes for birthing people and their infants and hence to reduce the total cost to society of perinatal mental health problems.

scholarly journals Perinatal depression screening using smartphone technology: Exploring uptake, engagement and future directions for the MGH Perinatal Depression Scale (MGHPDS)

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257065
Author(s):  
Rachel Vanderkruik ◽  
Edwin Raffi ◽  
Marlene P. Freeman ◽  
Rebecca Wales ◽  
Lee Cohen
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Perinatal Depression ◽  
Depression Scale ◽  
Perinatal Period ◽  
Health Impact ◽  
Depression Score ◽  
Future Research ◽  
Cross Sectional ◽  
Longitudinal Data Collection

Women may experience new-onset or worsening depressive disorders during pregnancy and the postpartum. If untreated, there may be detrimental consequences to the health and wellbeing of the woman and to her baby. There is a need for improved tools and approaches that can be easily and broadly implemented to effectively detect depression during the perinatal period. Early identification of depression during pregnancy is an important first step towards connecting women to treatment and preventing continued depression into the postpartum or beyond. This report provides preliminary findings from a pilot study of a digital screening app for perinatal depression expiring potential for app reach, engagement, and user demographics and mental health symptoms. With mainly passive recruitment efforts, we collected cross-sectional mental health data on over 700 women during the perinatal period, including women across over 30 countries. We report on mean depression scores among women during pregnancy and the postpartum as well as on constructs that are commonly comorbid with depression, including anxiety, sleep dysregulation, and perceived stress. Over half of the women during pregnancy and over 70% of women in the postpartum had a depression score indicative of clinical depression. Future research directions for this work and potential for public health impact are discussed, including longitudinal data collection and analyses of symptomology over time and embedding evidence-based digital therapeutics into the app as a means to increase access to mental health services.

Misconceptions about Veterans and Health

Pained ◽  
2020 ◽  
pp. 69-72
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Health Problems ◽  
Rehabilitation Services ◽  
Veterans Health ◽  
Depression And Anxiety ◽  
Health Concerns ◽  
Physical Health Problems ◽  
The Military

This chapter studies the health of veterans and the military. Since the first Gulf War in 1990, veterans have had worse mortality than the general population. Aside from mortality, mental health problems are a particular concern. More soldiers kill themselves than are killed on the battlefield. Beyond suicide, key mental health concerns among veterans include posttraumatic stress disorder (PTSD). Itself disruptive, PTSD foreshadows increased risks of physical health problems, substance use/misuse, homelessness, and violence. Less studied, but equally important, are high rates of depression and anxiety among veterans. Rates of chronic pain and physical disability are also high. These challenges make the Veterans Health Administration’s unique expertise in mental health care provision and rehabilitation services all the more crucial. For these reasons, moves to privatize veterans’ health care and narrow access to these services do veterans a disservice, shortchanging a fundamental social contract. The health of soldiers is the public’s health.

scholarly journals The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

2020 ◽  
Vol 17 (22) ◽  
pp. 8612
Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Older Patients ◽  
Common Mental Disorders ◽  
Health Policies ◽  
Depression And Anxiety ◽  
Treatment Gap ◽  
Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

scholarly journals Treatment gap and mental health service use among Syrian refugees in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D C Fuhr ◽  
C Ataturk ◽  
M McGrath ◽  
Z Ilkkursun ◽  
A Woodward ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Service Use ◽  
Mental Health Problems ◽  
Mental Health Service Use ◽  
Continuing Care ◽  
Syrian Refugees ◽  
Depression And Anxiety ◽  
Treatment Gap

Abstract Introduction Turkey hosts the highest number of Syrian refugees in Europe. Refugees are often vulnerable to situational forms of psychosocial distress as a consequence of exposure to war and violence which may result in more profound mental health problems if no treatment is sought. The aim of this study is to report evidence on mental health and psychosocial support (MHPSS) needs, access and barriers to MHPSS care among Syrians refugees living in Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Istanbul (Sultanbeyli) between February and May 2018. Data among 1’678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilization, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The prevalence of PTSD, depression and anxiety was 19.6%, 34.7% and 36.1% respectively. The treatment gap was 89% for PTSD, 90% for anxiety and 88% for depression. 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. Several structural and attitudinal barriers for not seeking care were reported. Conclusions To overcome the treatment gap, mental health care programmes need to be more responsive to the needs of Syrian refugees. Barriers to seeking and continuing care can be overcome by providing MHPSS services in the community which facilitate access to care. Community-based programmes of care should be supported by activities which increase awareness about mental health issues and tackle negative attitudes towards mental illness. Key messages This study provides the first nationally representative data on the mental health of Syrian refugees in Turkey, and shows that refugees have high mental health needs. Syrian refugees do not seek mental health care despite availability of mental health services in the community.

Effectiveness of Prompt Mental Health Care: Preliminary results from a randomized controlled trial

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Knapstad ◽  
L V Lervik ◽  
S M M Saether ◽  
L E Aaroe ◽  
O R F Smith
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Mental Health Care ◽  
Controlled Trial ◽  
Sensitivity Analyses ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Randomized Controlled

Abstract Background Prompt Mental Health Care (PMHC) service is a Norwegian initiative, adapted from the English ‘Improved Access to Psychological Therapy’ (IAPT), aimed at improving access to primary care treatment for anxiety and depression. Thus far, both PMHC and IAPT have been evaluated by cohort studies only. Albeit yielding promising results, the extent to which these are attributable to the treatment thus remains unsettled. This study investigates the effectiveness of PMHC compared to treatment as usual (TAU) at six months follow-up. Methods Randomized controlled trial with parallel assignment in two PMHC sites from November 2015 to March 2018. Participants were 681 adults (aged ≥18 years) considered for admission to PMHC due to anxiety and/or mild to moderate depression. These were randomly assigned on a 70:30 ratio. Main outcomes were recovery rates and changes in symptoms of depression and anxiety between baseline and follow-up. Primary outcome data were available for 73%/67% in the PMHC/TAU group. Sensitivity analyses based on observed patterns of missingness were conducted. Results A reliable recovery rate of 58.5% was observed in the PMHC group and 31.9% in the TAU group, yielding a between-group effect size (ES) of 0.61 [95% CI 0.37-0.85, p<.001]. The differences in degree of improvement between PMHC and TAU yielded an ES of -0.88 [95% CI -1.23-0.43, p < 0.001] for symptoms of depression and -0.60 [95% CI -0.90-0.30, p < 0.001] for symptoms of anxiety in favour of PMHC. All sensitivity analyses pointed in the same direction with small variations in point estimates. Findings were slightly more robust for depressive than anxiety symptoms. Conclusions The PMHC treatment was substantially more effective than TAU in alleviating symptoms of anxiety and depression. This adaptation of IAPT is considered a viable supplement to existing health services to increase access of effective treatment for adults who suffer from anxiety and mild to moderate depression. Key messages This study is the first to evaluate the effectiveness of an IAPT-like treatment model in terms of a randomized controlled trial. Prompt Mental Health Care was substantially more effective than TAU in alleviating symptoms of depression and anxiety at 6-months follow-up.

scholarly journals Study protocol: a clinical trial for improving mental health screening for Aboriginal and Torres Strait Islander pregnant women and mothers of young children using the Kimberley Mum's Mood Scale

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Emma Carlin ◽  
Sarah J. Blondell ◽  
Yvonne Cadet-James ◽  
Sandra Campbell ◽  
Melissa Williams ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Trial ◽  
Qualitative Methods ◽  
Real World ◽  
Torres Strait Islander ◽  
Perinatal Depression ◽  
Depression And Anxiety ◽  
Important Public Health ◽  
Torres Strait ◽  
Mood Scale

Abstract Background Improving the rates of, and instruments used in, screening for perinatal depression and anxiety among Aboriginal and Torres Strait Islander women are important public health priorities. The Kimberley Mum’s Mood Scale (KMMS) was developed and later validated as an effective and acceptable perinatal depression and anxiety screening tool for the Kimberley region under research conditions. Other regions have expressed interest in using the KMMS with perinatal Aboriginal and Torres Strait Islander women. It is, however, important to re-evaluate the KMMS in a larger Kimberley sample via a real world implementation study, and to test for applicability in other remote and regional environments before recommendations for wider use can be made. This paper outlines the protocol for evaluating the process of implementation and establishing the ‘real world’ validity and acceptability of the KMMS in the Kimberley, Pilbara and Far North Queensland in northern Australia. Methods The study will use a range of quantitative and qualitative methods across all sites. KMMS validation/revalidation internal consistency of Part 1 will be determined using Cronbach’s alpha. Equivalence for identifying risk of depression and anxiety compared to a standard reference assessment will be determined from receiver operating characteristic curves. Sensitivity and specificity will be determined based on these cut-points. Qualitative methods of phenomenology will be used to explore concepts of KMMS user acceptability (women and health professionals). Additional process evaluation methods will collate, assess and report on KMMS quality review data, consultations with health service administrators and management, field notes, and other documentation from the research team. This information will be reported on using the Dynamic Sustainability Framework. Discussion This project is contributing to the important public health priority of screening Aboriginal and Torres Strait Islander women for perinatal depression and anxiety with tools that are meaningful and responsive to cultural and clinical needs. Identifying and addressing barriers to implementation contributes to our understanding of the complexity of improving routine clinical practie. Trial registration The study was registered retrospectively on 15/05/2019 with the Australian and New Zealand Clinical Trial registry (ACTRN12619000580178).

scholarly journals Implementation of depression and anxiety screening in patients undergoing radiotherapy

2018 ◽  
Vol 7 (2) ◽  
pp. e000034 ◽  
Author(s):  
Adam L Holtzman ◽  
Deidre B Pereira ◽  
Anamaria R Yeung
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Screening Tool ◽  
Institutional Review Board ◽  
Anxiety And Depression ◽  
Standard Protocol ◽  
Depression And Anxiety ◽  
Clinical Workflow ◽  
Institutional Review ◽  
Anxiety Screening

Anxiety and depression are disabling, underdiagnosed issues that affect the management of oncology patients. Until recently, there has been no standard protocol for screening and treating these ailments at our cancer centre. The purpose of this institutional review board-approved study was to analyse the implementation of a screening tool in our clinical workflow with the aim of screening over 90% of patients and increasing referrals to mental health services by 50%.

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